Monday, December 22, 2014

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Mesothelioma Diagnosis

Cancer specialists utilize a number of diagnostic tools to accurately confirm mesothelioma, including blood tests such as MESOMARK and SOMAmer panel, imaging tests such as MRIs, CT scans, PET scans, X-rays and biopsies to investigate cancerous growth in tissue samples.

There is no clear path to a mesothelioma diagnosis for every patient. Because the disease is so rare and has such common symptoms, doctors sometimes confuse it for a less-serious illness or a different type of cancer.

Pinpointing the disease involves several procedures, including X-rays, CT scans, MRIs, biopsies and PET scans. Each of these tests is performed by a different medical professional, and most people get their diagnosis within two or three months from the time they notice their symptoms.

Diagnosing the cancer in its earliest stages supports a wider range of treatment possibilities that could extend your life expectancy. So it's important you start looking for a mesothelioma expert.

What Steps Lead to a Mesothelioma Diagnosis?

There are three steps to the mesothelioma diagnosis:

  • Checklist Icon

    Symptoms Begin to Show

    Patient detects symptoms, which general start to appear 20-50 years after exposure. These symptoms often mimic those of other diseases.
  • Doctor Icon

    Patient Consults Primary Care Physician

    The primary care physician discusses symptoms with patient. These doctors perform preliminary tests. If cancer is suspected, they refer patient to an oncologist.
  • Lung Icon

    Oncologist Makes Final Diagnosis

    The oncologist conducts a variety of tests based on the patient's health. Tests may include imaging scans, blood tests and biopsies to positively confirm a mesothelioma diagnosis..

If you find yourself in this situation, doctors will start the diagnostic process by asking about your medical history and by performing some standard physical exams. They should ask if you recall any personal past exposure to asbestos. 

Providing your doctor with a comprehensive work history can hasten an early diagnosis. Because mesothelioma is a rare cancer with nonspecific symptoms, doctors are unlikely to suspect the disease unless a patient describes a former job where asbestos exposures may have occurred.

By recognizing that they worked in a high risk industry, such as asbestos mining, construction or shipbuilding, patients can express concerns that their symptoms may be asbestos-related. 

Next, doctors will order imaging tests to identify any abnormal growths. If those show a suspicious mass that looks like mesothelioma, doctors will request a biopsy to confirm the diagnosis. They will take fluid or tissue samples during the biopsy.

During this process, you'll see several doctors. Patients usually visit a general practitioner, pulmonologist, radiologist, surgeon, pathologist and an oncologist. If any of these doctors suspect mesothelioma or another asbestos disease, that's a sign for any patient to get a second opinion from a mesothelioma specialist, an expert who has experience staging the cancer and treating people who have it.

Timeline for Diagnosing Mesothelioma:

    The timeline for diagnosing mesothelioma varies from patient to patient. It's based on the symptoms, doctor's experience with the illness, types of tests required to confirm the disease and wait times for the results of those tests.

    Here is a possible, and common, explanation for the lengthy process of diagnosing mesothelioma:
  • Day 1: Initial symptoms such as shortness of breath, fatigue and dry cough are common. It's usually not diagnosed at that time, but the doctor might order X-rays.
  • Day 2: X-rays determines fluid in the lungs could be pneumonia.
  • Day 3-Day 13: Physician prescribes antibiotic to treat pneumonia (10-day treatment) OR drains fluid in pleural cavity. No cancer cells detected in fluid.
  • Day 14: X-rays after treatment show lungs are clear. Doctor orders follow-up X-rays and asks patient to return in 30 days.
  • Day 44: Follow-up X-rays show fluid build-up in pleural cavity again. Doctor either drains fluid, which may again test negative for cancer cells, or treats the pneumonia with antibiotics again (add 10 days). Doctor orders PET scans and CT scans.
  • Day 54: Imaging scans show a possible underlying cause or recurrent pneumonia. Patient is referred to a surgeon for an appointment, which can take up to 15 days.
  • Day 69: Surgeon schedules a biopsy appointment, which can take up to 10 days.
  • Day 79: Surgeon takes biopsy, usually done via VATS and typically requires a three-day hospital stay for the patient. Lab work to confirm mesothelioma can take up to 10 days if surgeon sends biopsy to an outside lab.
  • Day 89 (approximately three months later): Mesothelioma confirmed if biopsy tests positive for the disease.


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Aqeel A. Zaman